Details to Consider When Choosing a Practice

Sidney Christiansen, MD

As you see the end of your training coming closer and closer, you may start clicking around online to gauge the job market. If you search one of the main job boards online, like indeed or DocCafe, you will probably find a variety of positions that seem appealing.

They might list platitudes like “great schedule,” “excellent administrative support,” or “light call requirement.” Essential duties of the job will be listed that could be generally applied to the practice of most physicians in any specialty. Simplified job descriptions like these are meant to distract you from the nuanced details about the dynamics of the practice and convince you that everything is perfect.

Do not be persuaded by these shining and oversimplified descriptions that picking the right practice fit is simply a click away. Finding a practice that will accommodate your personal and professional needs is not easy, but with diligence and early decision making, you can find a great fit. The following are some of the most important practice details you should consider when looking for a job.

Scope of Practice

Scope of practice might seem like more than just a detail, but it sometimes gets overlook by doctors fresh from training. As a physician, legally, you will have the largest scope of practice of any other healthcare professional. However, more senior physicians or administrators can have some say in what procedures and processes you can be involved in, sometimes putting limits on you regardless of your skills and credentials. Keep in mind, this may not be bad thing if you are looking to practice in a highly specialized way.

The first question you need to ask address is “what are the limits?” and secondly “who decides on my scope?” If you find that you do not like the answer to either of these, it is best to move on with your job search.

Potential Colleagues

Having a diverse set of colleagues can really be an asset to your career. Whether it is an experienced physician in the twilight of their career or a young physician with a background in cutting edge research, you have something to gain with working alongside of them.

Find out what the primary areas of interest are for the doctors in the group. You may be brought on to contribute to their specific fund of knowledge, or you may be needed as an expert in a different area that complements the practice. More practical considerations regarding your potential colleagues include their distance from retirement, how long they have been at the practice or where they trained.

If the practice offers the right mix of colleagues that can professionally challenge you yet support your growth as a new physician, this might be a great place to start your career.

Patient Assignment and Wait Times

How are your patients assigned? And once they get assigned to you, how long do they have to wait on average to see you? The type of patients you see/and your patient load can greatly impact your day-to-day practice and overall work satisfaction.

In a study conducted by Merritt Hawkins, the average wait time for a new patient appointment was 24 days in major urban areas and 32 days in mid-sized markets. Being overloaded with patients and creating long wait times for them can force you into a no-win situation.

Make sure to ask about patient assignment so you can judge whether it is equitable. This gives you the best chance of seeing new patients as quickly as possible and providing timely and effective care.

Turnover?

High turnover is not a good sign for potential physicians, especially if you are looking to put down roots within a practice and community. Ask the physicians at the practice about their current work and gauge how long each of them have been practicing with the organization. If a majority of physicians you speak to have only been around a couple years or there has been a recent exodus of physicians, this is a red flag.

To be certain about whether your potential employer has high turnover, reach out to former physicians about why they moved on. This will help clarify whether you can tolerate some of the difficulties that come with the job or if you should continue your search elsewhere.

Reputation

The reputation of the practice ties in very closely with the turnover. A well-run practice will typically attract good doctors, and those doctors will want to stick around and provide good care. Conversely, a poorly run practice will either deter good doctors or lose them quickly.

Contacts outside of the practice, but still within the community, can give you a more objective picture of the practice. These include bankers, realtors, teachers and competing practices. Do not be afraid to reach out and ask to understand the reputation of the practice for which you will be working.

Office Locations

The Physicians Advocacy Institute recently found that 38 percent of physicians are now employed by hospitals and health systems. What does this mean for you in looking for a new job? If you sign on with one of these practices that is part of a larger system, then you may be required to split your time at different locations. Ask about where these locations are, what kind of support staff will be available and what your hourly commitment must be.

One Step at a Time

Do not be swayed by the eye-catching yet oversimplified job postings you see online. If you are doing the job search well, it should require some tough questions, time and diligence. Reach out to Resolve so we can guide you along this process and help sort out the practice details that will make your career a success.